Utility of the serum galactomannan assay for the diagnosis of invasive aspergillosis in children with acute lymphoblastic leukemia

Avcu, Gülhadiye; Karapınar, Deniz Yılmaz; Akıncı, Ayşe Burcu; Siviş, Zuhal Önder; Şahin, Akkız; Bal, Zümrüt Şahbudak; Polat, Süleyha Hilmioğlu; Metin, Dilek Yeşim; Vardar, Fadıl; Aydınok, Yeşim

doi:10.1016/j.ijid.2016.10.027

Cited by 21 publications

(15 citation statements)

References 22 publications

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“…36 Rates of IA are usually lower in patients with acute lymphoblastic leukemia. [32][33][34]37,38 Patients with myelodysplastic syndrome (MDS) receiving intensive induction therapy have a high risk of IA, similar to AML patients. Conversely, IA is rare in MDS or in AML patients treated in frontline with azacitidine.…”

Section: Acute Leukemias and Myelodysplastic Syndromesmentioning

confidence: 99%

Invasive Pulmonary Aspergillosis

Ledoux

Guffroy

Nivoix

et al. 2020

Semin Respir Crit Care Med

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Invasive pulmonary aspergillosis (IPA) remains difficult to diagnose and to treat. Most common risk factors are prolonged neutropenia, hematopoietic stem cell or solid organ transplantation, inherited or acquired immunodeficiency, administration of steroids or other immunosuppressive agents including monoclonal antibodies and new small molecules used for cancer therapy. Critically ill patients are also at high risk of IPA. Clinical signs are unspecific. Early computed tomography (CT)-scan identifies the two main aspects, angioinvasive and airway invasive aspergillosis. Although CT-scan findings are not fully specific they usually allow early initiation of therapy before mycological confirmation of the diagnosis. Role of 18F-fludeoxyglucose positron emission tomography with computed tomography (18F-FDG PET/CT) is discussed. Confirmation is based on microscopy and culture of respiratory samples, histopathology in case of biopsy, and importantly by detection of Aspergillus galactomannan using an immunoassay in serum and bronchoalveolar lavage fluid. Deoxyribonucleic acid detection by polymerase chain reaction is now standardized and increases the diagnosis yield. Two point of care tests detecting an Aspergillus glycoprotein using a lateral flow assay are also available. Mycological results allow classification into proven (irrespective of underlying condition), probable or possible (for cancer and severely immunosuppressed patients) or putative (for critically ill patients) IPA. New antifungal agents have been developed over the last 2 decades: new azoles (voriconazole, posaconazole, isavuconazole), lipid formulations of amphotericin B (liposomal amphotericin B, amphotericin B lipid complex), echinocandins (caspofungin, micafungin, anidulafungin). Results of main trials assessing these agents in monotherapy or in combination are presented as well as the recommendations for their use according to international guidelines. New agents are under development.

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Section: Acute Leukemias and Myelodysplastic Syndromesmentioning

confidence: 99%

Invasive Pulmonary Aspergillosis

Ledoux

Guffroy

Nivoix

et al. 2020

Semin Respir Crit Care Med

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“…In Turkey, access to GM antigen test is available in most of the centers treating high-risk hematology patients, but publication of the experience in the international literature is limited (4)(5)(6)(7)(25)(26)(27). Only one center reported GM antigen as a useful marker for the diagnosis of IA where mold-active prophylaxis was not used (5).…”

Section: Resultsmentioning

confidence: 99%

“…After posaconazole prophylaxis was introduced in the clinical practice, the sensitivity of GM antigen was low, and the antifungal therapy was mainly triggered by radiological investigation (7). In addition, the benefit of GM antigen screening was extremely limited in pediatric patients (25,26).…”

Section: Resultsmentioning

confidence: 99%

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Galactomannan antigen detection as a screening tool for early diagnosis of invasive aspergillosis: Experience of Turkish adult patients

Metan¹,

Akan²

2018

Erciyes Med J

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Objective: The aim of the present study was to investigate the usefulness of galactomannan (GM) antigen as a screening test for the early diagnosis of invasive aspergillosis (IA) in adult patients in Turkish centers. Materials and Methods:PubMed was searched using the keywords "galactomannan" and "Turkey." Only studies that used the GM antigen as a screening tool in adult patients were included in the analysis.Results: Four peer-reviewed articles that matched the inclusion criteria were identified. A total of 314 adult patients with several hematological malignancies and who underwent allogeneic hematopoietic stem cell transplantation were included in the four studies. Patients were followed up for 459 neutropenia episodes. GM antigen testing was performed in 2662 serum samples. The sensitivity, specificity, positive predictive value, and negative predictive value were 23.07%-100%, 5.7%-90.36%, 6.7%-73.07%, and 55.5%-100%, respectively. Early diagnosis of IA by GM screening was found in only one patient in one of the four studies. Conclusion:The performance of the GM antigen test as a screening tool in Turkish centers was not promising. However, it can be used as a diagnostic test for patients with clinical and radiological findings suggesting invasive fungal disease.

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“…BAL GM sampling as a prognostic tool is not established and in vivo research suggests that it is not possible [46][47][48][49][50] . Although serum GM sampling during therapy to monitor response is highly useful, utility for BAL GM for the same purpose is not suggested.…”

Section: Gm Testing In Bronchoalveolar Lavage Fluidmentioning

confidence: 99%

A Review of a Diagnostic Tool: Galactomannan

Karapınar¹

2018

J Immunological Sci

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Invasive fungal infections, including invasive aspergillosis are associated with a high morbidity and mortality especially in immunocompromised patients. Diagnosis is often difficult due to several factors such as delay in clinical suspicion and the lack of spesific clinical findings. Galactomannan is a polysaccharide cell wall component of Aspergillus and galactomannan antigen detection has become widely used for diagnosis of invasive aspergillosis. Here, we tried to discuss the diagnostic value of the galactomannan test in the context of literature review.

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Utility of the serum galactomannan assay for the diagnosis of invasive aspergillosis in children with acute lymphoblastic leukemia

Cited by 21 publications

References 22 publications

Invasive Pulmonary Aspergillosis

Invasive Pulmonary Aspergillosis

Galactomannan antigen detection as a screening tool for early diagnosis of invasive aspergillosis: Experience of Turkish adult patients

A Review of a Diagnostic Tool: Galactomannan

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